世界移植杂志(英文版)最新文献

{"title":"Total intravenous anesthesia in kidney transplantation: A narrative review.","authors":"Ervandy Rangganata, Juanita Castellanos De Brigard, Apostolos Prionas, Nagy Habib, Vassilios E Papalois","doi":"10.5500/wjt.121739","DOIUrl":"10.5500/wjt.121739","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is the treatment of choice for end-stage renal disease. Whether propofol-based total intravenous anaesthesia (TIVA) confers advantages over volatile anaesthesia for perioperative stability, recovery, and graft outcomes remains debated.</p><p><strong>Aim: </strong>To synthesise the currently available comparative evidence on propofol-based TIVA versus volatile anaesthesia in adult kidney transplantation-focusing on haemodynamic stability, renal injury biomarkers, early graft function, recovery, postoperative nausea and vomiting (PONV), immunologic outcomes, and safety-and to identify the key evidence gaps and priorities for future research.</p><p><strong>Methods: </strong>We performed a narrative review following the Scale for the Assessment of Narrative Review Articles framework, with structured search and selection consistent with PRISMA-S reporting. PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, Scopus, and Web of Science were searched from inception to February 2026. Quality was appraised using Cochrane Risk of Bias 2 and ROBINS-I. Six studies were directly eligible in adult kidney transplant recipients; four supplementary mechanistic sources informed interpretation.</p><p><strong>Results: </strong>TIVA provided haemodynamic stability and immediate graft function equivalent to volatile anaesthesia. Urinary tubular biomarkers (kidney injury molecule-1, N-acetyl-β-D-glucosaminidase) were modestly lower with propofol in the VAPOR-1 trial (<i>n</i> = 57 living-donor pairs), but this did not translate into differences in delayed graft function, serum creatinine, or one-year graft survival. TIVA was associated with faster extubation and lower PONV, though recovery comparisons were confounded by opioid co-administration. Acute rejection rates did not differ significantly.</p><p><strong>Conclusion: </strong>Propofol-based TIVA is a safe and effective alternative to volatile anaesthesia in kidney transplantation. Whether the cellular-level biomarker signal translates into clinically meaningful renoprotection in higher-risk grafts requires adequately powered multicentre trials with standardised perioperative protocols.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"121739"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic penetrating keratoplasty for recalcitrant microbial keratitis: An update.","authors":"Ujjwal P Jha, Md A Alam, Prateek Nishant, Swati Kumari, Bharat Gurnani, Kirandeep Kaur, Ranjeet K Sinha, Sony Sinha","doi":"10.5500/wjt.120922","DOIUrl":"10.5500/wjt.120922","url":null,"abstract":"<p><p>Therapeutic penetrating keratoplasty (TPK) is a surgical procedure for salvaging medically refractory infectious keratitis. By replacing diseased, infected host corneal tissue with a full-thickness donor cornea, TPK aims to eliminate infection, preserves globe integrity and maintain vision. However, recurrence of infection in the graft remains a significant concern, particularly in cases caused by resistant organisms such as <i>Acanthamoeba</i>, <i>Pythium</i>, microsporidia, and certain bacterial and fungal pathogens. Although often curative, TPK carries a higher risk of endothelial rejection, reduced graft survival, and increased complications due to its open-sky approach. Lamellar keratoplasty, particularly deep anterior lamellar keratoplasty, has emerged as a promising surgical alternative in cases where the infection has spared the deeper corneal layers. Compared with full-thickness therapeutic keratoplasty, it offers advantages including improved graft survival, lower rejection rates and fewer postoperative complications. Nevertheless, recurrence may still occur in deep or extensive infections, and advanced cases with descemetocele, perforation, or limbal or scleral involvement often still require TPK. This article on TPK summarizes peer-reviewed literature from the past decade, incorporating recent advances in corneal surgery while placing the modern-day application of classically described techniques into perspective to strengthen surgical decision-making. Emphasis is placed on resistant pathogens, surgical indications, preoperative evaluation, anesthesia considerations, operative techniques, prognostic factors, and postoperative management strategies. Through this review, ophthalmic surgeons are expected to gain practical guidance for optimizing outcomes in complex corneal infections while addressing the challenges posed by resistant and atypical pathogens across diverse clinical scenarios.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120922"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Bridging knowledge gaps in organ donation - implications for transplantation and regenerative therapies.","authors":"Noura A A Ebrahim, Moamen O Othman, Neveen S Tahoun, Rasha A Salama, Soliman M A Soliman","doi":"10.5500/wjt.v16.i3.114798","DOIUrl":"10.5500/wjt.v16.i3.114798","url":null,"abstract":"<p><p>The ongoing global deficit of donor organs remains a significant obstacle for transplantation programs, with more than 100000 individuals currently listed for transplantation in the United States and an estimated 13 patients dying each day before receiving a suitable organ. This commentary integrates current evidence regarding public knowledge, perceptions, and barriers to organ donation, and connects these factors to the anticipated acceptance of emerging transplantation and regenerative medicine innovations. Despite widespread support for organ donation-reported among nearly 90% of United States adults-actual enrollment in donor registries remains disproportionately low, underscoring a persistent disconnect between positive attitudes and real-world participation. Recent findings from the United Arab Emirates, including the study by Al-Sharbatti <i>et al</i>, reveal notable gaps in understanding and fear of medical procedures as key deterrents to donor enrollment, trends similarly reported in regions such as Kazakhstan. These insights reaffirm that inadequate awareness and distrust of healthcare systems continue to impede donor registration, even in highly educated communities. Enhancing public education, promoting transparency, and fostering trust are crucial steps toward improving donation rates. As transplantation advances through innovations such as xenotransplantation, stem cell-derived tissues, and bioengineered organs, societal confidence will be pivotal in shaping their acceptance. Addressing current knowledge deficits and proactively engaging with ethical and societal considerations will be essential to fully realizing the potential of both conventional and next-generation transplantation therapies.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"114798"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pretransplant donor-specific antibodies and human leukocyte antigen mismatches on graft and patient outcomes: A cohort from Saudi Arabia.","authors":"Salem H Al-Qurashi, Muhammad Abdul Mabood Khalil, Hinda Hassan Khideer Mahmood, Alfatih Abdalla Altom, Yara Faisal Alqurashi, Zeyad Adel Alsaedi, Aileen Jean Dela Cruz, Maram Majid Alsharif, Rayan Mohammed Bawayan, Abdulrahman A Housawi, Nihal Mohammed Sadagah","doi":"10.5500/wjt.122485","DOIUrl":"10.5500/wjt.122485","url":null,"abstract":"<p><strong>Background: </strong>Pretransplant donor-specific antibodies (DSA) are frequently encountered in kidney transplant recipients, but their combined effect with human leukocyte antigen (HLA) mismatches on post-transplant outcomes is as yet not fully understood, particularly in Middle Eastern populations.</p><p><strong>Aim: </strong>To evaluate the effect of pretransplant DSA, HLA mismatches, and early graft function on acute rejection, graft loss, and patient survival, using detailed immunologic profiling and longitudinal follow-up to inform transplant management strategies.</p><p><strong>Methods: </strong>We conducted a retrospective study of 260 kidney transplant recipients with available pretransplant HLA typing and DSA assessment. Patients were followed for graft function, acute rejection, graft loss, and mortality. Multivariable logistic regression was used to identify predictors of preformed DSA and acute rejection, and Cox proportional hazards models were applied to evaluate factors associated with a composite outcome of acute rejection, graft loss, or death. Event-free survival was assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Acute rejection occurred in 10 patients (3.8%). In exploratory multivariable analyses, a higher HLA mismatch burden and suboptimal early graft function at 4 months post-transplant were associated with acute rejection; however, these findings should be interpreted cautiously because of the limited number of events. Pretransplant DSA was present in a subset of patients but was not independently associated with outcomes after adjustment for HLA mismatch and early graft function. A mismatch burden ≥ 7, reduced early graft function, and a history of sensitizing events were associated with a higher risk of the composite outcome. Kaplan-Meier analysis showed significantly lower event-free survival among patients with ≥ 7 HLA mismatches, while reduced early graft function further improved risk discrimination over time.</p><p><strong>Conclusion: </strong>Pretransplant DSA and HLA mismatch burden were both associated with post-transplant outcomes; however, the prognostic signal was largely driven by HLA mismatch and early graft function rather than DSA alone. A mismatch burden ≥ 7 was associated with reduced event-free survival, and early graft function further stratified risk. Induction therapy with antithymocyte globulin may have reduced the clinical impact of preformed DSA in sensitized recipients.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"122485"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiological mechanisms of cell death affecting graft survival in liver transplantation.","authors":"Christina Mouratidou, Efstathios T Pavlidis, Georgios Katsanos, Athanasios Kofinas, Alexandra G Marneri, Kalliopi E Stavrati, Georgios Tsoulfas, Theodoros E Pavlidis","doi":"10.5500/wjt.124992","DOIUrl":"10.5500/wjt.124992","url":null,"abstract":"<p><p>Early allograft dysfunction (EAD) is a significant complication of liver transplantation (LT). LT remains the sole curative treatment for patients with end-stage liver disease. EAD is correlated with heightened morbidity, extended stays in intensive care units, and decreased graft survival rates. Within the clinical practice, EAD presents a substantial challenge, necessitating vigilant monitoring, heightened clinical awareness, and prompt multidisciplinary intervention to prevent progression to primary graft nonfunction and multiorgan failure. Multiple forms of programmed cell death, including necrosis, apoptosis, necroptosis, pyroptosis, ferroptosis, autophagy, PANoptosis, and NETosis, have been implicated in graft injury. Apoptosis facilitates the regulated elimination of damaged or senescent hepatocytes <i>via</i> caspase-dependent pathways, whereas necroptosis and other necrotic mechanisms exacerbate caspase-independent tissue injury through membrane disruption and the release of inflammatory mediators. Pyroptosis, driven by inflammasome activation and gasdermin-mediated pore formation, further amplifies inflammatory signaling within the graft. Moreover, ferroptosis, characterized by iron-dependent lipid peroxidation, has emerged as a pivotal contributor to hepatocellular injury during hepatic ischemia-reperfusion events. Failure of hepatocellular protective mechanisms to adequately counteract energy depletion and oxidative stress during ischemia results in cell death, which subsequently activates immune and contributing to acute graft rejection.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"124992"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine perfusion distribution across clinical phenotypes in kidney transplantation: A national cohort study using unsupervised clustering.","authors":"Juanita Castellanos De Brigard, Ervandy Rangganata, Vassilios E Papalois","doi":"10.5500/wjt.121821","DOIUrl":"10.5500/wjt.121821","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Unsupervised machine learning identifies clinically meaningful subgroups across biomedical domains, yet remains underutilised in transplantation. Existing machine perfusion (MP) machine learning research relies on small cohorts with supervised models of variable performance, rarely investigating multivariate phenotypes integrating donor-recipient characteristics. Unsupervised methods can uncover latent phenotypes in high-dimensional data, revealing favourable-outcome groups and high-risk profiles overlooked by current scoring systems. Applying these methods to United Kingdom MP data may yield novel insights from the underexplored National Health Service Blood and Transplant (NHSBT) dataset. We hypothesised that MP cases occupy preferential positions within data-derived clinical phenotypes from unsupervised clustering, and these phenotypes retain structural stability and outcome stratification in the MP subgroup.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate whether MP cases are non-randomly distributed across unsupervised clinical clusters and whether MP status modifies cluster structure or outcome stratification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analysed the standard NHSBT kidney dataset comprising all United Kingdom adult kidney transplants from 2014 to 2024. The full cohort had 15904 cases and a machine-perfused subgroup of 544. Dimensionality reduction was conducted using a mixed-type principal component analysis embedding approach (FAMD-like) to generate a shared latent space for all features. Gaussian mixture model was fitted to the full cohort to define latent phenotypes, and then transferred to the MP subgroup. We performed descriptive post hoc characterisation of the cluster and assessed graft and patient survival outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six distinct clinical phenotypes were identified with moderate-to-good stability. MP cases showed non-random distribution, with notable enrichment in cluster 6 (40% of MP patients) and differential perfusion-type associations (hypothermic MP: Clusters 3, 5, 6; normothermic MP: Clusters 1, 4). When applied to the MP subgroup, cluster definitions remained stable, though with modestly reduced assignment confidence (mean entropy 0.815 &lt;i&gt;vs&lt;/i&gt; 0.783), indicating MP cases are embedded within the general population structure. Clusters retained outcome stratification in the MP subgroup, though outcome patterns diverged in specific phenotypes: Cluster 2 showed concentrated early graft failures (all within 2.07 years), while cluster 4 had lower patient survival despite stability in the full cohort. These findings suggest MP status may interact with underlying clinical phenotypes to modify outcome trajectories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;MP cases showed non-random cluster distribution and perfusion-type associations. Cluster structure remained stable with retained outcome stratification in the MP subgroup, though outcome patterns differed in specific phenotype","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"121821"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope for kidney transplantation in candidates with human immunodeficiency virus.","authors":"Amer Ashaab Belal, Rafael Aldaya Bourricaudy, Zahra Saba, Saba Ali, Issa Haddad, Alfonso H Santos","doi":"10.5500/wjt.120869","DOIUrl":"10.5500/wjt.120869","url":null,"abstract":"<p><p>Kidney transplantation continues to be the kidney replacement therapy of choice for patients with end stage kidney disease (ESKD) associated with a survival benefit over remaining on dialysis. Patients living with both ESKD and human immunodeficiency virus (HIV) have traditionally faced barriers accessing the kidney transplant (KT) waiting list given need for special considerations in addition to general listing requirements for KT candidates. The HIV Organ Policy Equity (HOPE) Act in 2013 and HOPE Act Variance in 2015 restricted HIV positive donor (+D) to HIV positive recipient (+R) transplants to research protocols or Institutional Review Board approved programs. Federal regulatory changes in 2024-2025 removed the above restrictions making HIV +D to HIV +R KTs standard of care practice for approved centers. Removal of the research criteria requirements in alignment with federal regulatory changes will likely expand access so that more individuals living with HIV can obtain a KT. Herein we will provide a narrative review of the available literature in the PubMed database on studies completed under the HOPE act as well as the special considerations in evaluating HIV positive renal transplant candidates and their subsequent post-transplant care to help ensure clinician and patient comfort in this era.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120869"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and machine learning in transplantation surgery care pathway.","authors":"Kavyesh Vivek, Vassilios Papalois","doi":"10.5500/wjt.122433","DOIUrl":"10.5500/wjt.122433","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning (ML) are increasingly applied across the transplantation pathway, offering advances in preoperative planning, perioperative management, and postoperative recovery. In preoperative care, deep learning algorithms improve anatomical assessment, volumetry, and graft weight estimation, while ML-based functional status evaluation and urgency scoring refine candidate selection. Predictive models incorporating metabolic and physiological data further support surgical eligibility and targeted prehabilitation strategies. Perioperatively, ML models outperform conventional approaches in predicting massive transfusion, intraoperative haemorrhage, and acute kidney injury, with explainable outputs enhancing interpretability and clinical trust. Robotic and AI-assisted surgical platforms demonstrate functional equivalence or superiority to conventional methods, reducing intraoperative complications and accelerating recovery, particularly in high-risk cohorts. Postoperatively, ML-driven models enable early prediction of sepsis, pneumonia, and graft dysfunction, while longitudinal markers such as the recipient-to-donor estimated glomerular filtration rate ratio and novel imaging or biomarker-based approaches inform long-term graft monitoring. Optimised perioperative strategies, including analgesic regimens and fluid management, further enhance donor recovery and rehabilitation outcomes. Cross-cutting innovations include imaging-based AI applications such as hyperspectral imaging for real-time graft viability assessment and deep learning for automated histopathological evaluation, which improve diagnostic speed, accuracy, and reproducibility. Multimodal models integrating electronic health records, intraoperative signals, ultrasound, and histology provide dynamic, system-wide insights into graft function and rejection risk, bridging diagnostic, prognostic, and therapeutic decision-making. AI and ML thus hold substantial potential to personalise transplant care and improve outcomes. Their translation into practice, however, requires rigorous validation, dataset diversity, and strong ethical and regulatory governance.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"122433"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alemtuzumab or basiliximab: Rethinking induction choice beyond acute rejection in kidney transplantation.","authors":"Pranjal Kashiv, Khushboo Saxena, Manish Ramesh Balwani, Amit Pasari, Vivek B Kute","doi":"10.5500/wjt.118000","DOIUrl":"10.5500/wjt.118000","url":null,"abstract":"<p><p>In this review summarizes studies presenting a propensity-matched comparative analysis evaluating alemtuzumab <i>vs</i> basiliximab induction in kidney transplant recipients with aligned immunological risk profiles and extended follow-up. Alemtuzumab, a potent lymphocyte-depleting agent, has therefore been widely adopted on the premise that deeper early immune suppression confers durable graft protection. Whether this assumption holds true beyond the early post-transplant period remains uncertain. A recent study demonstrates comparable rates of acute rejection between induction strategies, effectively neutralising rejection as the differentiating endpoint in contemporary practice. In contrast, clinically meaningful divergence emerges in longer-term outcomes. Alemtuzumab induction is associated with inferior graft function, higher rates of cytomegalovirus and BK viremia, increased post-transplant malignancy, and greater death-censored graft loss. These findings highlight a central paradox in transplant immunology: Strategies that achieve potent early immune suppression may incur delayed biological costs related to immune reconstitution, impaired immune surveillance, and cumulative graft injury. Collectively, the data argue for a shift away from rejection-centred metrics toward a more proportional and individualised approach to induction selection, in which long-term graft preservation and complication risk are weighed as carefully as early rejection prevention.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"118000"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian vein bypass for renal allograft salvage in iliac vein atrophy: A case report and review of literature.","authors":"Dung Duc Nguyen, Hiep Nhu Pham, Hung Khoa Nguyen, Kha Cong Le Bui, Tue Minh Vo, Hung Ngoc Pham","doi":"10.5500/wjt.120920","DOIUrl":"10.5500/wjt.120920","url":null,"abstract":"<p><strong>Background: </strong>Failure of venous drainage during reperfusion is an uncommon but serious complication of kidney transplantation that can rapidly compromise graft viability.</p><p><strong>Case summary: </strong>We report a 51-year-old woman with end-stage kidney disease undergoing living-donor kidney transplantation after long-term hemodialysis and prior left femoral dialysis catheterization. Intraoperatively, the left external iliac vein was unexpectedly found to be markedly atrophic, measuring only 3 mm, whereas the graft renal vein measured 12 mm. After initial anastomosis to the external iliac vein, reperfusion caused immediate graft congestion, indicating inadequate venous outflow. A short great saphenous vein interposition graft was therefore used to create an additional drainage pathway from the renal vein to the ipsilateral ovarian vein, which measured 3.7 mm. The graft decompressed immediately, and urine output began within 1 minute. Renal function remained stable, with a serum creatinine level of 65.4 μmol/L at 7 months, and 8-month imaging confirmed bypass patency and adaptive venous enlargement.</p><p><strong>Conclusion: </strong>A small ovarian vein with an autologous conduit can provide a salvage option for unexpected iliac venous pathology in kidney transplantation.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120920"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}